1 Topics in this report

A number of variables in the
SSCQ
relate closely to key monitoring information for local and national
government performance.

In this chapter the background for each of these indicators is
provided along with the key statistics from the established source
for each indicator. The indicator as formulated for discussion in
the
SSCQ
report is then described alongside national estimates from the
Core.

Note that
SSCQ
estimates differ in most cases and by varying degrees from the
accepted national performance indicator or longer-running time
series sources.
SSCQ is
designed to provide a suitable dataset for comparison between
subgroups of the core questions, particularly where the individual
surveys cannot produce such estimates due to insufficient sample
sizes or other methdoological reasons.
SSCQ
national point estimates do not replace the accepted statistics
from established sources.

SSCQ
indicators are generally formulated as two-state variables for
analysis. The indicator property is provided in a blue box followed
by a description of the counter-indicator. These are designed
wherever possible to match the description of current National
Indicator statistics.

1.1 Self-assessed General Health

Self-assessed general health is a critical measure of the
population's overall health status and a key marker of health
inequalities. One of the Scottish Government's National Outcomes is
the overall strategic objective for health: We live longer,
healthier lives
[5]. This is supported by a number of National Indicators
including 'improve self-assessed general health'
[6].

1.1.1National Estimates and Key Sources

The preferred source of statistics for time series at Scotland
level is the Scottish Health Survey. Since the baseline year (2008)
there has been little change in the proportion of adults who assess
their health as good or very good. The level has fluctuated between
74% and 77% over this period, though in the last three years has
been stable at 74%
[7].

Table 1: Good/very good general health,
SHeS

Good/Very good
general health
(% adults)

2008

75

2009

77

2010

75

2011

76

2012

74

2013

74

2014

74

1.1.2SSCQ
indicator

the proportion of
adults reporting good or very good general health

The counter-indicator is the proportion of adults reporting
fair, bad or very bad health or declining to answer. This differs
form the
SHeS indicator,
which excludes those declining to answer.

This
SSCQ
analysis is the preferred source for comparison across demographic
or area results. A comparison of
SSCQ and
census findings is provided in
Annex
A, and a comparison with constituent surveys in
Annex
B. The
SSCQ
shows around three quarters of adults reporting good or very good
general health between 2012 and 2014.

Across all response categories in the general health question,
responses are stable through the time series; changes between years
generally do not exceed combined confidence intervals.

Table 2: General health series, 2012-2014

2012

2013

2014

Good/Very good

73.8

± 0.7

75.2

± 0.8

74.1

± 0.7

Fair

19.0

± 0.6

17.4

± 0.6

18.6

± 0.6

Bad/Very bad

7.2

± 0.4

7.3

± 0.4

7.1

± 0.4

Detailed Categories

Very good

36.1

± 0.9

36.7

± 0.9

35.2

± 0.9

Good

37.6

± 0.8

38.5

± 0.9

38.9

± 0.8

Fair

19.0

± 0.6

17.4

± 0.6

18.6

± 0.6

Bad

5.6

± 0.4

5.7

± 0.4

5.5

± 0.4

Very bad

1.6

± 0.2

1.7

± 0.2

1.6

± 0.2

Weighted and Unweighted Bases

Adults

4,341,500

4,398,900

4,436,300

Sample

20,527

21,038

20,153

Under formal testing, the differences in the indicator between
years are not statistically significant.

Levels of good or very good general health observed in the
SSCQ
agree with those in the
SHeS across all
three years of
SSCQ
data. Confidence intervals on
SSCQ
estimate contain the point estimates from
SHeS in all
cases.

1.2 Long-term Limiting Health Conditions

In the Scottish Government's National Action Plan on long-term
conditions, long-term conditions are defined as 'health conditions
that last a year or longer, impact on a person's life, and may
require on-going care and support'. Conditions include a wide range
of mental and physical health conditions.

Long-term conditions account for 80% of all
GP consultations
and for 60% of all deaths in Scotland
[8]. The link with deprivation, lifestyle factors and wider
health determinants is also of importance in Scotland, given its
persistent health inequalities. Long-term conditions therefore
represent personal, social and economic costs both to individuals
and their families and to Scottish society more widely. Details of
long-term conditions are discussed in full in Chapter 8 of the
Scottish Health Survey
[9].

1.2.1National Estimates and Key Sources

The preferred source of statistics for time series at Scotland
level is the Scottish Health Survey
[10]. Timeseries data is available back to 1998 and is provided
in Table 3. In 2008 the wording of the question about long-term
conditions was changed in line with moves to harmonise questions
across all Scottish Government surveys and to bring it into line
with the definition of disability used in the Disability
Discrimination Act 2005.

The wording used in
SHeS prior to
this was: "Do you have any long-standing illness, disability or
infirmity? By long-standing I mean anything that has troubled you
over a period of time, or that is likely to affect you over a
period of time?".

The question used from 2008 onwards is worded as follows: "Do
you have any long-standing physical or mental condition or
disability that has troubled you for at least 12 months, or that is
likely to affect you for at least 12 months?".

The question changed again in 2012 to the current wording: "Do
you have a physical or mental health condition or illness lasting,
or expected to last, 12 months or more?"

For this reason trends in the prevalence of long-term illness or
conditions must be interpreted with caution. However the longer
term increase in the prevalence of long-term limiting health
conditions is likely linked to the aging population of
Scotland.

Table 3: Long-term limiting health condition,
SHeS

Long-term limiting health condition (% adults)

1998

24

± 1

…

2003

27

± 1

…

2008

26

± 1

2009

25

± 1

2010

28

± 1

2011

28

± 1

2012

32

± 2

2013

31

± 2

2014

31

± 2

Note that, contrary to the
SSCQ
reporting, these figures exclude those respondents who decline to
answer.

1.2.2SSCQ
indicator

the proportion of
adults reporting a long-term mental or physical health condition
that limits their day-to-day activities

The counter-indicator is the proportion of adults reporting no
long-term limiting health condition or declining to respond. This
differs form the
SHeS indicator,
which excludes those declining to answer.

Table 4: Long-term limiting health conditions series,
2012-2014

2012

2013

2014

Limiting Condition

23.9

± 0.7

22.2

± 0.7

23.2

± 0.7

No Limiting Condition

75.9

± 0.7

77.4

± 0.7

76.3

± 0.7

Weighted and Unweighted Bases

Adults

4,341,500

4,398,900

4,436,300

Sample

20,527

21,038

20,153

Across the three years of
SSCQ
there is no detectable change in the prevalence of long-term
limiting health conditions, in line with results from
SHeS in Table 3.
However estimates from the
SSCQ are
systematically lower than
SHeS
estimates.

Formulation of this indicator in
SSCQ is
slightly different due to exclusion of missing cases in the
SHeS result.
However this accounts for only a fraction of a percentage point
difference in the
SSCQ
estimate. The underlying difference is more fundamental, and likely
relates to context effects in the
SHeS collection.
Respondents are more likely to identify long-term conditions when
asked about them in the context of a specific interview about
numerous aspects of their health and wellbeing.

1.3 Smoking

Reducing smoking is a major priority for improving health. In
Scotland, tobacco use is associated with over 10,000 deaths (around
a quarter of all deaths) and around 128,000 hospital admissions
every year.
[11]

The Scottish Government's Tobacco Control Strategy sets a target
to reduce smoking prevalence to 5% or lower by 2034. The actions
taken by the Scottish Government to tackle the harm caused by
tobacco include legislation to prohibit smoking in public places,
which came into effect in March 2006, raising the age of sale for
tobacco from 16 to 18 in 2007, implementation of a tobacco retail
register in 2011, a ban on self-service sales from vending machines
in 2013, and the introduction of a tobacco display ban in shops
from 2013.

Two of the Scottish Government's National Performance Framework
(
NPF)
National Indicators are relevant to smoking.
[12] There is a specific indicator on reducing the proportion of
adults who are current smokers, as well as a more general indicator
on reducing premature mortality (deaths from all causes in those
aged under 75), for which smoking is a significant contributory
factor. Details of smoking behaviour are discussed in full in
Chapter 4 of the Scottish Health Survey
[13].

1.3.1National Estimates and Key Sources

The preferred source of statistics on smoking for time series at
Scotland level is the Scottish Household Survey. Smoking prevalence
has reduced from 25% of adults in the baseline year, 2006, to 20%
in 2014. In this context, the fall between 2013 and 2014 from 23%
to 20% is relatively large.

Table 5: Current smokers,
SHS

Current Smokers
(% adults)

1999

31%

2000

29%

2001

29%

2002

28%

2003

28%

2004

27%

2005

27%

2006

25%

2007

26%

2008

25%

2009

24%

2010

24%

2011

23%

2012

23%

2013

23%

2014

20%

1.3.2SSCQ
indicator

the proportion of
adults who report that they currently smoke cigarettes

The counter-indicator is the proportion of adults that report
not smoking cigarettes or declining to respond.

Table 6: Smoking prevalence, 2012-2014

2012

2013

2014

Currently smokes cigarettes

23.8

± 0.8

22.3

± 0.7

21.2

± 0.7

Non-smoker

76.1

± 0.8

77.5

± 0.7

78.6

± 0.7

Weighted and Unweighted Bases

Adults

4,341,500

4,398,900

4,436,300

Sample

20,527

21,038

20,153

According to the
SSCQ,
over three years the smoking rate has fallen from 23.8% in 2012 to
21.2% in 2014. This is consistent with the longer term trend
identified by the Scottish Household Survey, which has recorded a
ten percentage point fall from 1999 to 20.2% in 2014.
[14]

The confidence intervals on
SHS and
SSCQ
estimates overlap throughout the timeseries, indicating that these
estimates are not statistically different.

1.4 Mental Wellbeing

Wellbeing is measured in the Scottish Health Survey using the
Warwick-Edinburgh Mental Wellbeing Scale (
WEMWBS)
questionnaire
[15]. It has 14 items designed to assess: positive affect
(optimism, cheerfulness, relaxation) and satisfying interpersonal
relationships and positive functioning (energy, clear thinking,
self-acceptance, personal development, mastery and autonomy).
[16] The scale uses positively worded statements with a five-item
scale ranging from '1 - none of the time' to '5 - all of the time'.
Total score is the sum of these responses across the 14 questions.
The scale therefore runs from 14 for the lowest levels of mental
wellbeing to 70 for the highest.

WEMWBS
is used to monitor the National Indicator 'improve mental
wellbeing'. It is also part of the Scottish Government's adult
mental health indicator set, and the mean score for parents of
children aged 15 years and under on
WEMWBS
is included in the mental health indicator set for children.
[17]

1.4.1National Estimates and Key Sources

The mean score fell from 51.0 in 2006 to 50.0 in 2008, and has
remained at a similar level since (ranging between 49.7 and
50.0).

SHeSWEMWBS
Scores

Average WEMWBS Score

2008

50.0

2009

49.7

2010

49.9

2011

49.9

2012

49.9

2013

50.0

2014

50.0

1.4.2SSCQ
indicator

Average
SWEMWBS
score

SWEMWBS
is a shortened version of
WEMWBS
which is Rasch compatible. This means the seven items included have
undergone a more rigorous test for internal consistency than the 14
item scale and have superior scaling properties. The seven items
relate more to functioning than to feeling and therefore offer a
slightly different perspective on mental wellbeing
[18]. However, the correlation between
WEMWBS
and
SWEMWBS
is high at 95.4%
[19]. The
SWEMWBS
scale runs from 7 for the lowest levels of mental wellbeing to 35
for the highest.

SWEMWBS
statements are as follows:

I've been feeling optimistic about the future

I've been feeling useful

I've been feeling relaxed

I've been dealing with problems well

I've been thinking clearly

I've been feeling close to other people

I've been able to make up my own mind about things

Scoring on the
SWEMWBS
scale is not a straightforward sum of response scores, but underoes
a metric conversion, the effets of which are described in section
11.8.

The average
SWEMWBS
score after conversion was 24.5.

Prior to 2014, the
SWEMWBS
questions were not harmonised. Respondents who decline to answer
one or more of the seven
SWEMWEBS
questions are excluded from statistics.

1.5 Provision of Unpaid Care

The provision of unpaid care is a key indicator of care needs
and has important implications for the planning and delivery of
health and social care services.

Caring can have a detrimental effect on the health and wellbeing
of a carer and this can subsequently impact on the person that is
being cared for.
[20] Local authorities have a duty to assess a carer's ability to
care and the power to provide support where necessary.
NHS boards can
also be required to publish a carer information strategy setting
out how carers will be informed of their right to request an
assessment.

The Carers (Scotland) Bill was passed by the Scottish Parliament
on 4 February 2016 and sets out a range of measures intended to
improve the support given to carers
[21]. This includes the introduction of new duties on local
authorities to support carers who are assessed as needing support
and who meet eligibility criteria.

In 2014 the question wording was altered in the second quarter
of the collection period. As a result only three quarters of the
respondent group were asked the question in it's current form. For
further details see
section
11.8.

The care question in the
SHS was also
altered in Q2 2014. Previously it was asked of the highest income
householder about all members of the household. In Q2 2014 it moved
to the Random Adult module of the survey and so becomes comparable
to the other surveys in the core. The point estimate for the valid
three quarters of the
SHS was that
17% of adults provide unpaid care, based on a sample of 7,730
respondents. This estimate does not differ from the
SHeS result at
national level.

1.5.2SSCQ
indicator

This is the first year where it has been possible to provide
statistics from
SSCQ on
provision of care. The question was fully harmonised across the
three surveys in quarter 2 of 2014. Respondents in quarter 1 were
not harmonised and have therefore been excluded.

For that reason the sample size for this indicator is somewhat
smaller at 16,518 cases (compared to the sample of 20,153 for most
individual-level questions). To counteract any additional bias as a
result of this loss of sample, a specific weight for this question
has been calculated and is used for all analysis of unpaid care
provision. For further information see
section
11.8.

The proportion of
adults who provide help or support to family members, friends,
neighbours or others because of long-term physical or mental health
issues, disability or old age

The counter-indicator is the proportion of adults who do not
provide such care. Due to the methodological changes,
non-responding individuals are excluded.

Table 8: Provision of unpaid care,
SSCQ
2014

2014

Provides care

17.9

± 0.7

Not providing care

82.1

± 0.7

Weighted and Unweighted Bases

Adults

4,436,300

Sample

16,867

The
SSCQ
estimates that 17.9% of adults in Scotland provided unpaid care in
2014.

Although the
SSCQ
estimate is somewhat higher, the confidence intervals on
SHeS and
SSCQ
estimates overlap indicating that these results are not
statistically different.

1.6 Perceptions of Change in Local Crime Rate

Respondents who had lived in their current neighbourhood for 2
or more years were asked how they perceive the crime rate in their
area to have changed over the past year. The choices were 'a lot
less', 'a little less', 'about the same', 'a little more', 'a lot
more' crime, or 'don't know'. Responses were grouped into three
groups for analysis:

The preferred source of statistics on time series of the
perception of crime is the Scottish Crime and Justice Survey (
SCJS).
[23] The
SCJS
2014-15 found around three-quarters of adults perceived the crime
rate in their local area to have stayed the same or reduced in the
past two years.

Table 9: Perceived change in crime rate in local area,
SCJS

Perceived change in crime rate in local area in
last two years:

Column %

2008/9 to 2014/15

2012/13 to 2014/15

2008/9

2009/10

2010/11

2012/13

2014/15

About the same, or a little / lot less

69

71

73

76

75

5.7

*

-1.1

A little / lot more

28

25

23

20

20

-7.6

*

0.5

Following an increase between 2006 (65%) and 2012/13 (76%), the
proportion of adults who perceived the crime rate in their local
area to have stayed the same or reduced in the past two years has
not changed since 2012/13; the apparent one percentage point
decrease to 75% in 2014/15 is not a statistically significant
change.

Figure 2: Perceptions of how crime rates have changed
locally in the past two years (Scottish Crime Surveys)
[24]

1.6.2SSCQ
indicator

Excluding those who
have lived in the neighbourhood for less than 2 years, the
proportion of adults reporting crime in their local area to be 'a
lot less', 'a little less' or 'about the same'

The counter-indicator is the proportion of adults reporting
crime in their area to be 'a little more', 'a lot more' or
declining to respond (excluding those who have lived in the
neighbourhood for less than 2 years). For this reason the sample
base and population is lower than for other crime indicators.

A comparison of estimates from data pooled from the
SCJS
2014-15 and estimates in
SSCQ
2014 is provided in
Annex
B.

Table 10: Perception of Local Crime Rate series,
SSCQ
2012-2014

2012

2013

2014

About the same/A little/A lot less

75.8

± 0.8

77.6

± 0.8

77.4

± 0.9

A little/A lot more

19.3

± 0.8

16.0

± 0.7

16.2

± 0.8

Detailed Categories

A lot less

1.9

± 0.3

1.7

± 0.3

2.0

± 0.3

A little less

7.6

± 0.5

8.1

± 0.5

8.6

± 0.6

About the same

66.3

± 0.9

67.8

± 0.9

66.8

± 1.0

A little more

13.9

± 0.7

12.2

± 0.6

12.2

± 0.7

A lot more

5.4

± 0.4

3.9

± 0.4

3.9

± 0.4

Weighted and Unweighted Bases

Adults

3,667,000

3,870,500

3,891,800

Sample

16,869

17,398

16,518

77.4% of adults reported that crime in their area had decreased
or stayed the same in 2014. This represents an increase from 2012
of 1.6 percentage points.

Compared with Table 9, estimates provided by
SCJS
are somewhat lower than the levels recorded by
SSCQ.
This may relate to context effects in the
SCJS
collection. It is thought that respondents may be more likely to
answer more negatively in response to questions about local crime
rates when asked about them in the context of an interview about
crime, victimisation and policing.

1.7 Confidence in Police

Survey respondents, regardless of whether they had ever been in
contact with the police, were asked how confident they were in the
ability of the police in their local area to undertake specific
aspects of police work.

A. prevent crime

B. respond quickly to appropriate calls and information from the
public

The preferred source for these statistics is the Scottish Crime
and Justice Survey (
SCJS),
which provides a time series back to 2008-09. The results of the
SCJS
are which are used for National Indicators
[25] and Justice Outcome Indicators
[26].

1.7.1National Estimates and Key Sources

The preferred source of statistics on time series of the
perception of crime is the Scottish Crime and Justice Survey (
SCJS).
[27]

As shown in Table 11, since 2008/09 there have been
statistically significant increases in public confidence across
each of the six measures. Between 2012/13 and 2014/15, there were
small but statistically significant decreases in four of the police
confidence measures (the proportion of adults confident in their
local police forces ability to investigate incidents, deal with
incidents, respond quickly and solve crimes). The changes in the
results for the other two measures (the proportion of adults
confident in their local police forces ability to catch criminals
and prevent crime) were not statistically significant.

the proportion of
adults reporting that they are 'very confident' or 'fairly
confident' in the ability of Police to perform a given
function

The counter-indicator is the proportion of adults reporting that
they are 'not very' or 'not at all' confident or declining to
respond.

The proportion of positive responses to the individual questions
are provided in Table 12. Detailed breakdowns of these questions by
all four response options (very/fairly/not very/not at all
confident) are included in supplementary tables
[29].

Table 12: Police confidence questions series,
SSCQ
2012-2014

Very/fairly confident in Police to...

2012

2013

2014

A

prevent crime

57.2

± 0.9

57.4

± 0.9

58.2

± 1.0

B

respond quickly to appropriate calls and information
from the public

65.6

± 0.9

66.5

± 0.9

66.3

± 0.9

C

deal with incidents as they occur

68.3

± 0.8

68.2

± 0.9

68.0

± 0.9

D

investigate incidents after they occur

70.2

± 0.8

69.3

± 0.9

70.3

± 0.9

E

solve crimes

62.1

± 0.9

62.6

± 0.9

63.2

± 0.9

F

catch criminals

60.1

± 0.9

60.5

± 0.9

61.6

± 0.9

Weighted and Unweighted Bases

Adults

4,341,500

4,398,900

4,436,300

Sample

19,516

19,395

18,499

The proportion of positive responses across all six questions
has not changed significantly over the three years of
SSCQ.

Confidence intervals on estimates from
SSCQ
across all six police confidence questions overlap with estimates
produced by
SCJS;
the results are not statistically different. Any differences that
do arise in the point estimates provided by the two sources may
relate to context effects in the
SCJS
collection, where respondents may answer differently in response to
questions about confidence in policing when asked about them in the
context of an interview about crime and victimisation.

A novel analytical technique has been employed to analyse
patterns of response across these questions in the
SSCQ.
These results are released as "Statistics in Development" in an
accompanying paper
[30]. An overview of underlying classes revealed by this analysis
is provided in Figure 3, but subgroup analyses are not discussed in
this report except to reference the supplementary paper. Comments
on these results are welcome and should be directed to the
SSCQ
Project Team:
sscq@gov.scot.